AB1609 ECONOMIC IMPACT OF HOSPITAL STAYS FOR UVEITIS PATIENTS IN THE UNITED STATES: AN ANALYSIS OF THE NATIONAL INPATIENT DATABASE
Authors: K. Chauhan
Journal: Annals of the Rheumatic Diseases (2023)

Background Uveitis is the most common extraarticular manifestation in patients with spondyloarthritis. It may be the first presentation of spondyloarthritis. The combination of effects on vision, systemic disease and side effects of treatment have a significant impact on patient’s life. Uveitis affects all age groups and results in visual impairment over a long duration of the patient’s lifetime. Hence, treatment cost due to uveitis is similar to the common eye conditions such as cataract, age related macular degeneration and glaucoma. Objectives There is a lack of national level data regarding the medical cost of hospital stay of uveitis patients. The objective of our study is to identify health care expenses for patients hospitalized with uveitis in the United States. Methods The National Inpatient Sample (NIS) is used for this study. It is a de-identified, random sample data of inpatient hospitalizations in the United States. It is the largest all-payer database containing data on more than seven million hospital stays. Its large sample size is ideal for examining national estimates. We collected data from 2016 to 2020 and ICD-10 codes were used to identify uveitis cases. NIS uses the Clinical Classifications Software Refined (CCSR) categories which aggregates ICD-10 codes into 530 clinical categories. ICD-10 codes for inflammatory eye conditions are assigned to the category uveitis and ocular inflammation. Patients hospitalized with primary diagnosis of uveitis were included. Length of hospital stay; hospital charge and cost were collected. Charge is the amount hospital billed and cost represents the actual cost of hospital stay. Results Average charge for hospital stays for uveitis patient is approximately 60,000 US dollars and has increased from 2016-2020. Similarly, cost of hospital stays and length of stay increased during the study period. Majority of uveitis inpatients are discharged to home, smaller percentage are discharged to rehab, nursing home or to home health care. Results are shown in the Table 1. Conclusion Economic burden of inpatient uveitis on health care is significant and has continued to increase from 2016 to 2020. Strategy and policy for providing better outpatient care for uveitis patients would help in reducing the number of hospital admissions and costs of stay. References [1] Bertrand PJ, Jamilloux Y, Ecochard R, Richard-Colmant G, Gerfaud-Valentin M, Guillaud M, Denis P, Kodjikian L, Sève P. Uveitis: Autoimmunit and beyond. Autoimmun Rev. 2019 Sep;18(9):102351.PMID: 31323361. [2] Rosenbaum JT. The eye in spondyloarthritis. Semin Arthritis Rheum. 2019 Dec;49(3S):S29-S31.PMID: 31779847. Table 1. Attributes of Hospital Stay for Uveitis patients in the United States: 2016-2020: National Inpatient Sample. 2016 2017 2018 2019 2020 Estimate (Standard error) Estimate (Standard error) Estimate (Standard error) Estimate (Standard error) Estimate (Standard error) Number of discharges 1270 (111) 1260 (103) 1340 (114) 1645 (116) 1290 (109) Average Length of Stay (In days) 5.8 (0.361) 6.7 (0.451) 6.2 (0.319) 7.2 (0.57) 7.1 (0.667) Aggregate hospital charges* (In US $) 64,574,007 (7251445) 69,891,369 (8262178) 8,4085,579 (10294805) 109,200,748 (10618923) 89,381,020 (9376801) Aggregate hospital cost^ (In US $) 16,884,141 (1924031) 17,972,462 (2122834) 19,125,946 (2158514) 28,756,464 (3008420) 23,935,615 (2628843) Average hospital charge per stay (In US $) 50,846 (4095) 55,469 (4611) 62,750 (5469) 66,383 (4659) 69,288 (5127) Average hospital cost per stay (In US $) 13,295 (1064) 14,264 (1151) 14,273 (1045) 17,481 (1394) 18,555 (1488) Number of discharges transferred to nursing home or rehab. 125 (26) 175 (34) 140 (26) 190 (32) 170 (32) Number of discharges to home health care. 120 (24) 120 (25) 145 (30) 235 (37) 165 (29) *Charges: Amount hospital billed. Aggregate Charges: The sum of all charges for all hospital stays in the U.S. ^Costs: Actual costs of hospital stay. Charges are converted to costs using cost-to-charge ratios based on hospital accounting reports from the Centers for Medicare and Medicaid Services (CMS). Acknowledgements: NIL. Disclosure of Interests None Declared.